Sometimes a broccoli spear’s path to a child’s stomach is paved with melted cheese.

That’s the struggle day care officials often battle as they prepare food menus. It’s a tricky balance among cost, nutritional value and what kids actually will eat — so that food is going into stomachs and not into the trash.

“We tread that line between what will they eat and what won’t they eat,” said Lori Braley, program director for Apple Tree Children’s Centers in Sioux Falls. “They’re much more likely to eat Froot Loops than they are Cheerios.”

But the national obesity epidemic is bringing the issue to the forefront not just in the nation’s schools, which implemented new, healthier National School Lunch Program rules last year, but in day care centers as well. Almost one in three children in the United States is considered obese or overweight. In South Dakota, 32 percent of children 5 to 19 are overweight, while 16 percent are considered obese.

Both larger and in-home centers are being urged to provide healthier options that include more fresh fruits and vegetables and whole grains and fewer sugary treats, sometimes at the behest of parents who want to see healthier options on the menu. Day care centers also can enroll in the federal Child and Adult Care Food Program, which allows them to receive subsidies if they follow the nutritional guidelines, though it’s not mandatory.

Beyond the federal program, the state is recommending foods such as more fresh fruits, vegetables and whole grains but has stopped short of requiring them. That will change, too, as the U.S. Department of Agriculture works to revamp the Child and Adult Care Food Program meal patterns as it did for the school lunch program.

It could be a few years yet before implementation, but Melissa Halling, CACFP program director of the state Department of Education, said any changes now will help centers be more prepared later.

“It’s going to be more expensive,” Halling said of how day cares could be affected by the expected changes.

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“It would create problems. We don’t know what problems could be created,” because it depends on the changes.

Jackie Payne has been concerned about nutrition at her child’s day care for the past few years. She has three kids, ranging in ages from 3 to 6, two of whom are in day care at least part-time, and said she was surprised to see the large amount of convenience foods on the menu, including Cheetos served at her previous day care.

When she changed day cares about a year ago to Apple Tree, their menu was a factor in deciding where to go. She also worked with the center director in providing parental input on menu revisions the center has been undergoing.

Even at home, Payne said, it can be a struggle to get kids to eat healthful foods. When broccoli was on the menu recently, for instance, they served it with melted cheese so her kids would eat it.

“It’s a struggle between cost, convenience and what kids will eat,” Payne said. “I think we want our kids to be as healthy as they can be.”

Earlier path to eating right

The federal meal plan program subsidy varies according to in-home or day care centers and also according to income.

The program specifies what each meal must include and what the serving should be.

Experts say a push for healthier eating in day cares is important because the earlier those healthier habits are implemented, the better.

“When a child starts school, just exposing them to healthy foods and options and activities then, not to say you’ve lost the child, but it’s kind of a hard process to change those developed behaviors in which you could have started at the age of 2, or 1, or infancy,” said Lutina Cochran, education and training specialist for the National Food Service Management Institute at the University of Mississippi.

Local day cares make changes

Improving the menu can be as easy as getting rid of higher fat or sugary items such as cookies, and increasing lean meats, low-fat milk and fresh fruits and vegetables as much as possible.

Apple Tree, which has four centers and about 750 kids, started making changes at the behest of some concerned parents and to spice up the menu, which had become stagnant. Things such as chicken nuggets and hot dogs were making appearances a lot more frequently, Braley said.

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They’ve gone through three revisions. They’ve switched to whole grain items when possible, including tortillas, pasta and bread, and their fruit juices now come in 100 percent juice rather than syrup.

Not everything has been successful.

They tried to put spinach in sandwich wraps but recently switched to romaine lettuce, because too many kids were picking it out, thinking there were leaves in their sandwich, Braley said.

While sweet potato fries and tater tots have gone over well, “Mashed sweet potatoes, we just gave up on. We were just throwing that out all the time,” Braley said.

Tomatoes are being added to the tomato soup, which Braley fears will remain at the bottom of bowls more often than she’d like, at least to begin with.

“Eventually, the children are going to get to where they won’t even notice it,” she said.

Payne said she would like to see a little more variety in the menu but is happy with the changes.

“I think they do a good job at offering healthy options,” she said.

At EmBe’s two day care centers with about 500 kids, and a before- and after-school program, change has been slow. After hearing comments from parents a few years ago, staff members started working with a nutritionist and tried to implement changes but found it was hard on their budget.

Karla Johnson, director of child care services for EmBe, said it was a learning process.

Slowly, they’ve been making changes such as switching from canned vegetables to frozen, and during the past two years they’ve tried to incorporate more fresh fruits and vegetables such as sliced cucumbers and apples and celery and carrot sticks, Johnson said. They’ve also started serving a hot breakfast instead of cereal because kids weren’t eating the healthier varieties.

“It’s a slow process,” she said.

“We’ll never be able to afford it all at once. You just don’t go from a burger diet to a steak and lobster diet overnight.”

Johnson said snacks often can be a challenge. At EmBe, items such as Chex Mix and Nutri-Grain bars are part of the rotation, which Johnson acknowledges parents probably don’t like to see. But she said they are a lesser of two evils.

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“I know food is one thing that will never, ever be able to please everyone, and we’ll just try to do the best we can to provide a variety and be as healthy as we can afford,” Johnson said.

Overall, Halling said about half the day care centers she’s surveyed are trying to make changes.

Last year, they implemented an award program for centers that meet guidelines above and beyond the regular program. It recognizes centers for offering fresh fruits, vegetables and whole grains several times a week and also has a physical fitness element.

So far, no centers have applied, but Halling said that might be in part because there is only recognition, no monetary gain for taking the time to apply, and nutrition sometimes can be an item that falls to the wayside for other, more pressing needs.

Cochran said there are a lot of things centers can do to increase nutrition and also keep the budget under control.

Simple things such as serving baked, not fried, foods can increase nutrition, and baking from scratch instead of using prepared convenience foods can be more budget friendly and also allow for the use of whole grains, she said.

Comparison shopping also is key, which Braley said has helped them control costs and find the best value at Apple Tree.

They have experienced an increase in the food budget since making changes. She said whole-grain pasta probably is their biggest expense as well as the whole-grain pizza crust.

Cochran and Halling said education and involvement also are key in getting kids to try new foods. That can be anything from offering family-style eating, to growing a garden or even reading books about vegetables and fruits.

Even making sure teachers eat the foods and are positive makes a difference, Braley said.

“Everything that they have not tried is new to them. It may take 10 to 12 times before they have a positive influence,” Cochran said.

“Eventually, if you have a positive attitude and continue to introduce it in a positive light, then they’re more prone to try a food.”